Nursing Elites

1. A healthcare provider is providing instructions to the parent of an adolescent client who has a new prescription for Albuterol, PO. Which of the following instructions should the healthcare provider include?

• A. You should not use this medication for an acute asthma attack.'
• B. Tremors may be an adverse effect of this medication.'
• C. Long-term use of this medication can lead to hyperglycemia.'
• D. This medication can inhibit skeletal growth.'

Correct answer: B

Rationale: Tremors may occur as a result of excessive stimulation of beta2 receptors in skeletal muscles when using Albuterol. It is important to educate the parent about potential adverse effects to ensure proper monitoring and management of the adolescent client's medication regimen.

2. A nurse orienting a newly licensed nurse is reviewing the procedure for taking a telephone prescription. Which of the following statements should the nurse identify as an indication that the newly licensed nurse understands the process?

• A. A second nurse enters the prescription into the client's medical record.
• B. Another nurse should listen to the phone call.
• C. The provider can clarify the prescription when he signs the health record.
• D. I should omit the 'read back' if this is a one-time prescription.

Correct answer: B

Rationale: The correct answer is B: 'Another nurse should listen to the phone call.' When taking a telephone prescription, having another nurse listen to the phone call is essential to prevent errors in communication. This process helps ensure accuracy and reduces the risk of misinterpretation. Choice A is incorrect because entering the prescription into the client's medical record is not related to verifying the accuracy of the telephone prescription. Choice C is incorrect as the provider clarifying the prescription upon signing the health record doesn't address the immediate need for verification during the phone call. Choice D is incorrect because the 'read back' is a crucial step in confirming the accuracy of all prescriptions, regardless of whether they are one-time or recurring.

3. When reviewing facility policies for IV therapy with the team, a nurse manager should remind the team that which technique helps minimize the risk of catheter embolism?

• A. Performing hand hygiene before and after IV insertion
• B. Rotating IV sites at least every 72 hours
• C. Minimizing tourniquet time
• D. Avoiding reinserting the needle into an IV catheter

Correct answer: D

Rationale: Avoiding reinserting the needle into an IV catheter is crucial to minimizing the risk of catheter embolism. Reinserting the needle can lead to the severing of the catheter's end, potentially causing a catheter embolism, a serious complication. The other options, while important for IV therapy safety, are not directly related to preventing catheter embolism.

4. What should a patient avoid while taking Angiotensin-converting enzymes?

• A. Salt substitutes
• B. Foods high in potassium
• C. Foods high in sodium
• D. All of the above

Correct answer: A

Rationale: Patients taking Angiotensin-converting enzyme (ACE) inhibitors should avoid salt substitutes because they can contain potassium chloride, which may lead to hyperkalemia. It is important to restrict potassium-rich foods while on ACE inhibitors, but the primary concern with salt substitutes is their potassium content.

5. A healthcare provider is reviewing the health history of a client who is starting therapy with tamoxifen. The healthcare provider should recognize that tamoxifen is contraindicated in which of the following clients?

• A. A client with a history of deep-vein thrombosis
• B. A client with a history of migraine headaches
• C. A client with a history of hypertension
• D. A client with a history of anemia

Correct answer: A

Rationale: Tamoxifen is contraindicated in clients with a history of thromboembolic events, such as deep-vein thrombosis, due to the increased risk of blood clots. The estrogenic effects of tamoxifen can further increase the risk of thromboembolic events, making it unsafe for individuals with a history of deep-vein thrombosis. Choice B (migraine headaches), Choice C (hypertension), and Choice D (anemia) are not contraindications for tamoxifen therapy. Migraine headaches, hypertension, and anemia do not pose the same risk of adverse effects related to blood clot formation as deep-vein thrombosis does.

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